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Vaccine passports are coming in many countries: we explore how behavioural science can help understand what the wider impact might be on behaviour
Although the has ruled out the introduction of vaccine passports for access to nightclubs and other indoor venues many countries are reviewing their use as a means of certification that the holder of the passport has received the full COVID vaccine. These were recently introduced in France and are now required to enter public places such as restaurants, bars and high-speed trains.
One of the motives for the introduction of these passports is to encourage more young people to get the full vaccination. Recent NHS data for England, for example, shows that under 70 per cent of 18 to 24-year-olds have received a first dose, despite being eligible for vaccination since June 18, and a little over 30 per cent have had the second shot. By contrast, more than 90 per cent of over-50s have had their second shot.
Opinion polls suggest that the use of vaccine passports, are popular but at the same time, as recent street protests in France show, can provoke angry responses. We identify a number of issues that we consider will be important to unpick in the coming days and week:
Dread risk: Paul Slovic famously identified ‘dread risk’ as a critical in determining our response to a hazard. The higher a hazard’s score on this factor, the more people want to see its current risks reduced, and the more they want to see strict regulation used to reduce that risk. The challenge for younger people is that the chance of suffering severe illness and death from Covid-19 is low for most young adults, meaning the danger is typically not seen as existential. This could mean that the desire to take action to reduce risk, or indeed support regulation to reduce risk (such as vaccine passports), is inevitably lower for this group.
Undesirable choices: Choices that young adults make are between COVID (unpleasant but probably not fatal) or vaccination which is very largely safe but is understood, nevertheless, to also come with the possibility of very rare serious reactions such as inflammation of heart tissues in addition to the common transient side-effects such as tiredness, headache and nausea. Research by Simona Botti on making choices between what might be considered unpleasant alternatives, suggests that we are more likely to dislike making a decision. Her research also suggests in these instances we are more likely to off-load our decision making to others: the question then comes of course, of which others it might be offloaded to. It may be the government or public health guidance but could also be peers - in which case there is a great deal more unpredictability of the outcomes.
Market versus social norms: In a well-known study, a nursery had a problem with parents picking their kids up late causing staff to have to stay later than scheduled. Because of this the nursery decided to implement a fine every time a child was picked up after hours. The problem was that things actually got worse: previously there were social norms that parents were violating which staff could appeal to. Now parents considered the price to pick a child up late was worth the fine. The staff tried to reverse the policy but to no avail - once there is a transitions from social to market norms, it becomes hard to reverse.
There is surely a danger that just such as issue will happen here – vaccination is currently a system of social norms: by linking it to access to nightclubs and other forms of entertainment there is a danger that vaccination is then seen as an economic style of exchange. While this may work for some, others may see this as legitimizing their non-vaccinated status.
Fairness: This issue is very influential on behaviour – perceived lack of fairness can drive resentment, a powerful emotion. There is a great deal of discussion of this in relation to incentivisation schemes —Liverpool City Council recently offered free tickets to a Liverpool football game on Twitter to vaccinated fans. There was a huge negative reaction with many saying it was unfair to give prizes to latecomers. There could be a similar issue of perceived lack of fairness with vaccine passports – particularly if it is seen to disproportionately target a particular population.
Counter-cultural identities: Lack of access to activities due to COVID passports could mean that people are motivated to get the full vaccine but for some it can also harden attitudes: it certainly moves motivation from being intrinsic (something we personally want to do) to extrinsic (something we are motivated to do for external rewards). Being part of a group that is excluded may create a new counter-cultural identity for these individuals and as such may run the risk of a ‘slippery slope’ to more extreme positions on the topic. By contrast, research we carried out last year indicated a high proportion of the UK population were ‘COVID-vaccine hesitant’ – but as people learnt about the vaccine and saw other people having positive outcomes the levels of hesitancy declined. The danger is that attitudes polarise so it can be more difficult to engage with the non-vaccinated population.
Vaccination continues to be a topic where behavioural science has a key role to play. For example, COVID is not like other conditions such as measles where a vaccination then creates near full immunity - the efficiency of COVID vaccines are much lower. Of course, with enough people vaccinated then we can reach a situation of near full immunity for the population, but getting there is complex. This means that behavioural science has a key role to play to understand why the reasons for lack of vaccination and findings ways to address it.
We will continue to examine the way behaviours unfold and assess the degree to which these mechanisms we discussed above play out.